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Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys

Evans-Lacko, S., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Benjet, C., Bruffaerts, R., Chiu, W. T., Florescu, S., de Girolamo, G., Gureje, O., Haro, J. M., He, Y., Hu, C., Karam, E. G., Kawakami, N., Lee, S., Lund, C., Kovess-Masfety, V., Levinson, D., Navarro-Mateu, F., Pennell, B. E., Sampson, N. A., Scott, K. M., Tachimori, H., ten Have, M., Viana, M. C., Williams, D. R., Wojtyniak, B. J., Zarkov, Z., Kessler, R. C., Chatterji, S. and Thornicroft, G. (2017) Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychological Medicine, 48 (9). pp. 1560-1571. ISSN 0033-2917

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Identification Number: 10.1017/S0033291717003336

Abstract

Background: The treatment gap between the number of people with mental disorders and the number treated represents a major public health challenge. We examine this gap by socio economic status (SES; indicated by family income and respondent education) and service sector in a cross-national analysis of community epidemiological survey data. Methods: Data come from 16,753 respondents with 12-month DSM-IV disorders from community surveys in 25 countries in the WHO World Mental Health Survey Initiative. DSM-IV anxiety, mood, or substance disorders and treatment of these disorders were assessed with the WHO Composite International Diagnostic Interview (CIDI). Results: Only 13.7% of 12-month DSM-IV/CIDI cases in lower-middle-income countries, 22.0% in upper-middle-income countries, and 36.8% in high-income countries received treatment. Highest-SES respondents were somewhat more likely to receive treatment, but this was true mostly for specialty mental health treatment, where the association was positive witH education (highest treatment among respondents with highest education and a weak association 178 of education with treatment among other respondents) but non-monotonic with income (somewhat lower treatment rates among middle-income respondents and equivalent among those with high and low incomes). Conclusions: The modest, but nonetheless stronger, association of education than income with treatment raises questions about a financial barriers interpretation of the inverse association ofSES with treatment, although future within-country analyses that consider contextual factors might document other important specifications. While beyond the scope of this report, such an expanded analysis could have important implications for designing interventions aimed at increasing mental disorder treatment among socio-economically disadvantaged people.

Item Type: Article
Official URL: https://www.cambridge.org/core/journals/psychologi...
Additional Information: © 2017 Cambridge University Press
Divisions: Personal Social Services Research Unit
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Sets: Research centres and groups > Personal Social Services Research Unit (PSSRU)
Date Deposited: 27 Oct 2017 09:45
Last Modified: 20 Jul 2019 02:37
Projects: R01MH070884, R13-MH066849, R01-MH069864, R01-DA016558, FIRCA R03-TW006481
Funders: United States National Institute of Mental Health, John D. and Catherine T. MacArthur Foundation, Pfizer Foundation, United States Public Health Service, Fogarty International Center, Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical Inc., GlaxoSmithKline, Bristol-Myers Squibb
URI: http://eprints.lse.ac.uk/id/eprint/84977

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